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If Your Spouse Needs Nursing Home Care, You Might Want to Consider a “Medicaid Annuity” – but Do Your Homework!

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Annuities can be a controversial topic among retirement planners, with some suggesting everyone should have an annuity while others insisting that no one should. As is typically the case, the truth lies somewhere in the middle: in some situations, an annuity can be an ideal solution for guaranteed income in retirement. That’s why we were intrigued by this recent CNBC article, written by reporter Sarah O’Brien, describing a use for annuities that may not have occurred to you. For some couples, purchasing the right kind of annuity can be a way to protect assets that might exceed Medicaid limits. The CNBC article nicknames these “Medicaid Annuities.”

Medicaid Qualification Puts Couples in a Bind

“It’s not uncommon for older couples to reach a point when nursing home care is needed for one spouse — and the cost isn’t something they were prepared for,” O’Brien writes. This is a topic we talk about constantly here at AgingOptions. Couples (and singles) who fail to make plans to cover the cost of long-term care are heading into a potentially devastating situation.

It still surprises some seniors to learn that Medicare doesn’t cover long-term care. That means, unless a senior in need of nursing care qualifies for benefits through the Veterans Administration, Medicaid is the only government-paid benefit that most can look to. The problem is that Medicaid limits how much in assets a couple can retain before benefits kick in.

“While Medicaid steps in when a person’s financial resources are minimal, some couples face the possibility of depleting their own assets to pay for nursing home care,” says O’Brien  — a cost which, says Genworth, exceeds $8,800 per month, or nearly $106,000 a year. That cost often leaves the healthy spouse in a precarious financial situation.

Medicaid Limits Vary By State

When planning for Medicaid qualification, it’s important to note that limits on allowable income and assets – including home equity – can vary significantly depending on what state you live in. Because AgingOptions is based in Washington State, we consulted a website called Medicaid Planning Assistance for current limits. (This website is provided by the American Council on Aging.)  For married couples where only one spouse needs care, the maximum allowable assets (not counting home equity) totals $137,400.

In Washington State, income isn’t really an issue for couples. “When only one spouse of a married couple applies for nursing home Medicaid or a Medicaid Waiver, only the income of the applicant is counted,” says the website. “The income of the non-applicant spouse is disregarded and has no impact on the applicant’s income eligibility.” The same is true for home equity: as long as the “healthy” spouse is living in the couple’s home, the equity is exempt from Medicaid calculations.

Medicaid Annuity Helps Avoid Painful Spend-Down

What if you have more than the limit and still need help? Couples whose assets exceed Medicaid limits are in a bind. “They realize they’re in a tough position because they have extra cash that will prevent them from qualifying for Medicaid initially,” certified financial planner Jeffrey Levine told CNBC. “So, the question is what can they do to preserve the value of those assets?”

The process of “spending down” assets generally involves paying off debt or making purchases that won’t hurt Medicaid eligibility. Sometimes couples end up self-paying the care bill for a period until their assets are sufficiently depleted. But, says O’Brien, “another option may be purchasing what’s called a Medicaid annuity. This strategy basically allows you to convert countable assets (for Medicaid eligibility purposes) into an income stream for the healthy spouse — and not have it factor into the calculation.”

But this suggestion comes with a warning label. “There are lots of details to know before running out to purchase an annuity for this purpose,” says CNBC. “And its usefulness may be limited to a situation with no better alternatives.”  Financial planner Levine, sounds a negative note. “It’s not a great option,” he told CNBC, “but may be the best of a series of bad options.”

What to Know About a Medicaid Annuity

As CNBC explains, here’s how a Medicaid annuity can work. “Say a couple has $100,000 above their state’s asset cap,” O’Brien writes. “They would purchase an annuity with it that’s payable to the healthy spouse, based on their own life expectancy.”  But there are restrictions. We consulted the Medicaid Planning Assistance website and here are some of the key ones in Washington:

  • The annuity must be immediate, with payments starting immediately;
  • It must be irrevocable, which means the money can’t be withdrawn;
  • It must be a fixed annuity, not variable;
  • It must be non-transferable;
  • The State of Washington must be named as remainder beneficiary

There’s more to know, so as we said, do your homework. “If there’s a chance a Medicaid annuity could be useful in your situation, it’s wise to get guidance from a local attorney who specializes in elder law and knows your state’s laws regarding this strategy,” CNBC warns.  And be sure to look into other options. Other state-sanctioned Medicaid qualification programs may be a better fit for your situation.

As always, please contact our partners at Life Point Law for answers to all your questions about Medicaid and other aspects of retirement planning.

My Life, My Plan, My Way: Get Started on the Path to Retirement Success

At AgingOptions we believe the key to a secure retirement is the right retirement plan – yet statistics show that 70 percent of retirement plans fail. That’s why for nearly two decades we’ve been dedicated to the proposition that a carefully-crafted, fully comprehensive retirement plan is the best answer to virtually any contingency life may throw your way as you age.  Our slogan says it all: My Life, My Plan, My Way.

When it comes to retirement planning, most people focus on one fairly narrow issue: money. Financial planning is an important component of retirement planning. However, people heading towards retirement often make the mistake of thinking that a little financial planning is all that’s required, when in fact most financial plans are woefully inadequate. What about your medical coverage? What if you have to make a change in your housing status – will that knock your financial plan off course? Are you adequately prepared legally for the realities of retirement and estate planning? And is your family equipped to support your plans for the future as you age?

The best way we know of to successfully blend all these elements together – finance, medical, housing, legal and family – is with a LifePlan from AgingOptions. Thousands of people have discovered the power of LifePlanning and we encourage you to the same. Simply visit our website and discover a world of retirement planning resources.  Make certain your retirement planning is truly comprehensive and complete with an AgingOptions LifePlan.  Age on!

(originally reported at www.cnbc.com)

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